[What are the alternatives to betablockers in 2009?].
Betablockers reduce mortality by 30% after a myocardial infarction. The anti anginal effects of betablockers are also very well established. They improve survival after a non cardiac surgery in patients at high cardiovascular risk. Atenolol should nevertheless be avoided for primary cardiovascular protection in patients with hypertension older than 55 yrs. This may not apply to more selective betablockers, or betablockers with vasodilator effects. We also now have another bradycardic agent, ivabradine, which may prove very useful in heart failure patients who cannot tolerate a betablocker.
van de Borne
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Service de Cardiologie, Hôpital Erasme, Bruxelles. Philippe.Van.de.Borne@erasme.ulb.ac.be
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000787:Angina Pectoris / Q000188:drug therapy / Q000517:prevention & control; D001262:Atenolol / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000188:drug therapy; D006333:Heart Failure / Q000188:drug therapy; D006349:Heart Valve Diseases / Q000188:drug therapy; D006801:Humans; D000077550:Ivabradine; D009203:Myocardial Infarction / Q000188:drug therapy*; D017202:Myocardial Ischemia / Q000188:drug therapy; D018579:Patient Selection; D013237:Stereoisomerism; D014665:Vasodilator Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D014665:Vasodilator Agents; D000077550:Ivabradine; D001262:Atenolol